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NL 2010/10

Right to abortion still only exists on paper: a Council of Europe decision about the obligations of healthcare providers is temporarily overthrown

There’s a well-known format of question and answer jokes known as “Armenian Radio” jokes, where the punchline begins “in principle yes, but...” In principle yes, every woman in Austria has a right to a medical abortion – but what are you supposed to do if they’re not available anywhere near where you live?”

In fact, availability of a (medical, properly carried out) abortion in Austria is the exception rather than the rule: in the Federal Provinces of Burgenland, Tirol and Vorarlberg there is not a single medical facility that provides abortions. In the other Federal Provinces there are only very few providers – only in Vienna is there a degree of choice. In all, abortions are performed at only 17 out of 100 Austrian hospitals.

What hospital owners like to portray as a decision of conscience by the doctors, in most cases translates to intense ideological or political pressure. So, in Lower Austria there are reports of a personal directive by the Governor to the effect that no abortions may be performed in “his” regional hospitals. In the Federal Province of Salzburg, against the order of the female (Socialist) Governor, a conservative doctors’ lobby ensures that there is only one gynaecologist, a woman, willing to perform abortions. This results in the ludicrous arrangement of a gynaecologist having to travel there from Vienna every Saturday in order to ensure women’s right to abortion – otherwise the women themselves would have to undertake a journey of several hundred kilometres.

Of course, all hospitals run by (Catholic) faith healthcare providers prevent their doctors from performing such interventions, even threatening dismissal.

Council of Europe should spell out hospitals’ obligations

A report debated by the Council of Europe in summer 2010 hoped to put an end to that dreadful situation. On 20th July 2010, United Kingdom representative Christine McCafferty introduced document No. 12347, entitled “Women’s access to lawful medical care: the problem of unregulated use of conscientious objection”, on behalf of the Social, Health and Family Affairs Committee.

The draft resolution said:

“The practice of conscientious objection arises in the field of health care when healthcare providers refuse to provide certain health services based on religious, moral or philosophical objections. While recognising the right of an individual to conscientiously object to performing a certain medical procedure, the Social, Health and Family Affairs Committee is deeply concerned about the increasing and largely unregulated occurrence of this practice, especially in the field of reproductive health care, in many Council of Europe member states. There is a need to balance the right of conscientious objection of an individual not to perform a certain medical procedure with the responsibility of the profession and the right of each patient to access lawful medical care in a timely manner.”

Establish that interests of both parties should be given equal weight

The 47 Member States should therefore ensure that medical services seen as controversial are provided and are available to patients even against the conscientious objections of individual doctors, for the right to decide freely on matters of conscience only applies to persons directly involved in medical interventions (employees such as doctors etc.), but not for indirectly affected staff (eg. nurses, facility staff). In particular, interventions such as pregnancy terminations must not be denied in specific State medical establishments or clinics. Instead, institutions must ensure that they employ doctors willing to carry out such interventions.

The basis for this is the need for balance between the individual right to freedom of conscience and the right of the patient to access lawful medical care in a timely manner.

The draft was swamped by proposed amendments (89 in total) by (religious fundamentalist) opponents, until the original meaning of the draft resolution had been entirely reversed so that those who had originally proposed it had no choice but to reject it. So, for the moment, the rights of a patient still cannot be implemented against those of the doctor.

Museum of Contraception and Abortion, Mariahilfer Gürtel 37, 1150 Wien, Wednesday to Sunday 2- 6 pm or 24 hours a day at http://en.muvs.org/